HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Author home page(s): Domenico Paparella Giuseppe Visicchio Giuseppe Capone Giosuè Lionetti Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Cappabianca, G. Articles by de Luca Tupputi Schinosa, L. Search for Related Content PubMed PubMed Citation Articles by Cappabianca, G. Articles by de Luca Tupputi Schinosa, L. Related Collections Cardiac - other

Ann Thorac Surg 2006;82:2170-2178
© 2006 The Society of Thoracic Surgeons

---

Original Articles: Cardiovascular

Preoperative C-Reactive Protein Predicts Mid-Term Outcome After Cardiac Surgery

Division of Cardiac Surgery, Dipartimento d’Emergenza e Trapianti d’Organo, University of Bari, Bari, Italy

Accepted for publication June 15, 2006.

^_* Address correspondence to Dr Paparella, Division of Cardiac Surgery, Dipartimento d’Emergenza e Trapianti d’Organo, University of Bari, Piazza Giulio Cesare 11, 70100 Bari, Italy (Email: paparella{at}tin.it).

BACKGROUND: C-reactive protein (CRP) is a known risk factor for cardiovascular events in the healthy population and in patients with coronary artery disease. High CRP levels before cardiac surgery are associated with worse short-term outcome, but its role after discharge home remains unknown. The study objective was to evaluate the effect of CRP on short-term and mid-term outcome after cardiac surgery.

METHODS: From August 2000 to May 2004, values for preoperative CRP were available for 597 unselected patients undergoing cardiac operations. CRP was used to divide this cohort in two groups: a low inflammatory status (LHS) group of 354 patients with CRP of less than 0.5 mg/dL, and a high inflammatory status (HIS) group of 243 patients with a CRP of 0.5 mg/dL or more. Follow-up lasted a maximum of 3 years (median, 1.8 ± 1.5 years) and was 92.6% complete.

RESULTS: In-hospital mortality was 8.2% in the HIS group and 3.4% in the LIS group (odds ratio [OR], 2.61; p = 0.02). Incidence of postoperative infections was 16.5% in the HIS group and 5.1% in the LIS group (OR, 3.25; p = 0.0001). Sternal wound infections were also more frequent in the HIS group (10.7% versus 2.8%; OR, 3.43; p = 0.002). During follow-up, the HIS group had worse survival (88.5% ± 2.9% versus 91.9% ± 2.5%; OR, 1.93; p = 0.05) and a higher need of hospitalization for cardiac-related causes (73.6% ± 6% versus 86.5% ± 3.2%; OR, 1.82; p = 0.05).

CONCLUSIONS: Patients undergoing cardiac surgery with a CRP level of 0.5 mg/dL or more are exposed to a higher risk of in-hospital mortality and postoperative infections. Despite surgical correction of cardiac disease, a high preoperative CRP value is an independent risk factor for mid-term survival and hospitalization for cardiac causes.

This article has been cited by other articles:

				L. M. van Venrooij, R. de Vos, M. M. Borgmeijer-Hoelen, C. Haaring, and B. A. de Mol Preoperative unintended weight loss and low body mass index in relation to complications and length of stay after cardiac surgery Am. J. Clinical Nutrition, June 1, 2008; 87(6): 1656 - 1661. [Abstract] [Full Text] [PDF]